title: Oxygen consumption during oxygenated hypothermic perfusion as a measure of donor organ viability.
abstract: Hypothermic machine perfusion (HMP) for the preservation of kidneys, recovered from extended criteria organ donors (ECDs), presents the opportunity for assessing ex vivo parameters that may have value in predicting postimplantation organ viability. Organ perfusion and vascular resistance are the parameters most frequently cited as the basis for the decision to use or discard a donor kidney. The limitation of these measures is emphasized by the observation that a significant percentage of ECD kidneys with poor perfusion parameters can provide life-sustaining function after transplantation. It has been suggested that whole organ oxygen consumption (OC) during oxygenated HMP may better reflect the proportion of viable tissue in the organ and more reliably predict posttransplant organ function. Our study correlates renal OC and renal vascular resistance (RVR) during oxygenated HMP with postpreservation glomerular filtration rates (GFRs) in rodent kidneys after 24 hours of oxygenated HMP. Kidneys from adult rodents were preserved for 24 hours using oxygenated HMP and static cold storage (SCS). During oxygenated HMP preservation, organ OC, renal organ flow rates, and RVR were serially measured. After the preservation period, organs were mounted onto a Langendorff device for warming to normal body temperature and measurement of GFR. Oxygen consumption and RVR during HMP were correlated with postpreservation GFR. Oxygen consumption during oxygenated HMP was significantly correlated (r2 = 0.871; p < 0.05) with postpreservation GFR, suggesting that higher OC predicts better postpreservation GFR. In contrast, RVR was poorly correlated with postpreservation GFR (r2 = 0.258; p = 0.199). Glomerular filtration rate in SCS kidneys was 0.002 ± 0.003 ml/min/g. We demonstrate that measurement of organ OC during oxygenated HMP may have significant value in predicting postpreservation organ function.
authors.affiliation: Department of Anesthesiology, University of Texas Health Science Center, San Antonio, Texas 78229-3900, USA. bunegin@uthscsa.edu
authors.forename: Leonid
authors.initials: L
authors.lastname: Bunegin
authors.forename: Gleb P
authors.initials: GP
authors.lastname: Tolstykh
authors.forename: Jerry F
authors.initials: JF
authors.lastname: Gelineau
authors.forename: A Benedict
authors.initials: AB
authors.lastname: Cosimi
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Anderson
mesh_terms: D000818:Animals; D007036:Hypothermia, Induced / Q000295:instrumentation / Q000379:methods; D007668:Kidney / Q000098:blood supply / Q000502:physiology*; D016030:Kidney Transplantation / Q000379:methods*; D010101:Oxygen Consumption / Q000502:physiology*; D010477:Perfusion / Q000295:instrumentation / Q000379:methods; D051381:Rats; D017207:Rats, Sprague-Dawley; D014019:Tissue Donors; D014022:Tissue Survival / Q000502:physiology*